Diseases of the Colon & Rectum

, Volume 41, Issue 6, pp 793–796 | Cite as

Passage of a large bowel cast caused by acute ischemia

Report of two cases
  • Gregory J. Ardigo
  • George F. Longstreth
  • Lynn A. Weston
  • Frederick D. Walker
Case Reports


PURPOSE: We report two cases of spontaneous anal passage of a large bowel ‘cast’ caused by acute ischemic injury. METHODS: Clinical, laboratory, endoscopic, and pathologic features were reviewed, and the literature was searched for similar cases. RESULTS: An 85-year-old male who had undergone aortic surgery recovered from rectosigmoid ischemia after undergoing a descending colostomy. A 74-year-old male with severe pancreatitis developed a postischemic sigmoid stricture but did not have operative treatment before death of pneumonia three months after the episode. A literature review revealed six cases of passage of a large bowel cast. In the eight total patients, infarcted muscularis propria was found in seven specimens, five patients had a diversion procedure, and seven survived. CONCLUSION: Passage of a large bowel cast is an extraordinary complication of ischemia that often requires diverting surgery, and most patients survive the ischemic injury.

Key words

Bowel ischemia Bowel cast Aortic surgery Pancreatitis 


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Copyright information

© The American Society of Colon and Rectal Surgeons 1998

Authors and Affiliations

  • Gregory J. Ardigo
    • 1
  • George F. Longstreth
    • 1
  • Lynn A. Weston
    • 2
  • Frederick D. Walker
    • 3
  1. 1.Department of MedicineKaiser Permanente Medical Care ProgramSan Diego
  2. 2.Department of SurgeryKaiser Permanente Medical Care ProgramSan Diego
  3. 3.Department of PathologyKaiser Permanente Medical Care ProgramSan Diego

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